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Assisted Dying Debate

On 7th November 2012 the Florence Nightingale School of Nursing and Midwifery hosted a lively debate on the highly topical and controversial issue of assisted dying.

The campaign for assisted dying has gained momentum in recent years, with several widely publicised cases of people with terminal conditions asserting a right to die, either through withdrawal of treatment or a more instant death by pharmacological means. Campaigners are demanding a change to the law to allow assisted death. For better or worse, legalisation of assisted dying would lead to changes in principles and practice of end-of-life care. With contributions from two nursing scholars, and an audience of mostly nurses, the debate highlighted ethical, practical and professional issues from a nursing perspective.

Chaired by Dr Niall McCrae, lecturer in mental health nursing, the debate was led by two prominent voices on either side of the argument. The motion ‘This house believes that the clinical role in end-of-life care should not extend to assisted dying’ was proposed by Rob George, Professor of Palliative Care at the Cicely Saunders Institute within King’s Health Partners, and Consultant Physician in Palliative Care at Guy’s & St Thomas’ Hospitals. The case for the motion was seconded by nursing lecturer Joanna de Souza, who specialises in end-of-life care. Opposing the motion was Ray Tallis, latterly Professor of Geriatric Medicine at the University of Manchester and consultant physician in healthcare of the elderly. Professor Tallis chairs the campaign body Healthcare Professionals for Assisted Dying. Seconding the opposing case was Trisha Grocott, Reader at King’s College London, and an expert in palliative care in the hospice.

The debate was preceded by an initial vote from the audience, which showed 44% for the motion (against assisted dying) and 56% in favour of a change to the law. Assertive cases were heard from either side, followed by stimulating open debate on issues such as conscientious objection, and the risk that a desire to die may be due to depression or other psychological problems. After summarising arguments, a final vote was taken.

This showed a substantial shift towards the motion, rising to 61% against legalising assisted dying. This debate thus produced a clear indication that whereas nurses are receptive to the notion of assisted dying, on considering the implications for patient care they are more cautious.